As mammary carcinoma is the most frequent malignant disease in women, early detection is important. There are numerous diagnostic tools available, the mammogram being the gold standard. The next step would be developing a treatment plan that is individualized for the patient and the type of carcinoma. The following article will teach you to accurately diagnose mammary carcinoma and to initiate the appropriate therapy.

Breast cancer (mastocarcinoma) is the most common form of cancer among women. Consequently, it will be encountered by doctors as part of their work in hospitals and medical practice. This disease exhibits a heterogeneous pattern including different histological subtypes, which may differ considerably in their degree of malignity and, consequently, in their clinical symptoms and therapy. The following article helps you to understand the clinical picture of mastocarcinoma, identify its symptoms and to classify its histology correctly.

00:01
Our topic, benign tumors.
00:04
We will walk through a
bunch of benign tumors.
00:06
you’ll notice that
in this table,we do not discuss
fibrocystic change at all.
00:12
Fibrocystic change is not a tumor.
It is a change.
00:14
We’ll walk through in greater
detail what that means.
00:18
Our first benign tumor
here will be fibroadenoma.
00:22
Characteristics:Small, mobile,firm mass with sharp edges.
00:27
This is well encapsulated.
00:30
Small, maybe freely mobile.
00:33
Who is your patient?Young female.
00:35
Just like fibrocystic change.
00:38
Both of these
patients are young.
00:42
Increase in size and tenderness
with increased estrogen.
00:45
Here once again,we’re looking at hormonal
type of changes.
00:50
Fibrocystic change,
we did the same.
00:52
So how can you distinguish
one from the other?An adenoma is an adenoma.
00:55
It is a tumor.
00:57
It does not have the
fibrosis type of change.
00:59
It does not have the
cystic type of change.
01:01
You won’t find a blue dome
type of appearance here.
01:04
You do not have
sclerosing adenosis norwould you truly have –Well, maybe perhaps you could
have epithelial hyperplasia.
01:09
But the point is,this is a sold tumor,which is located most
commonly by the stromadeep in the breast.
01:17
So it could be difficult
to actually palpatebecause of where it’s located.
01:21
But if you can,
it’s freely mobileand if you were
to take it out --this is a tumor, so
you can take it out.
01:27
And when you do,well, because of
where it’s located,there might be a tumor that
might be rather hemorrhagic.
01:32
There might be a little
bit of blood in there.
01:35
Not a precursor for
breast cancer.
01:37
True benign tumor.
01:40
Then we have a papilloma,intraductal papilloma.
01:44
What’s occurring here?A small tumor that grows
in the lactiferous duct.
01:49
So if you’re clearly not
at all good with your --as I said, your
breast apparatus,I’ll bring this to
your attention.
01:55
But if you want to get
ahead a little bit,at least take a look at
what’s your breast --and what it looks like as we go
from the nipple back to the stroma.
02:03
Your lactiferous duct would be –well, as the name implies,
lactiferous means milk.
02:08
So you have your
lactiferous sinusesthat are responsible
for ejecting the milkso that the nipple, when the
newborn is ready to suckle,the milk then comes out with the help
of oxytoxin and company, correct?What happens here is that
the lactiferous ductmay then undergo, well,
in other words, a tumor.
02:28
And so therefore when that happens,
you can imagine that this --you call this a papilloma.
02:33
So you can actually
call this a tumor.
02:36
Now the notes are the
following, it’s important here.
02:38
Here, this is a benign tumor.
02:40
However, the nipple discharge
here will be bloody.
02:43
So if therefore, if your
female patient tells youthat her shirt, her undershirt or
whatnot or even her bras and such,when she takes of her bras, that
she finds blood in her breasts.
02:56
At first, you are a little –oh actually not just a little --you’re very much concernedand you want to rule out
breast cancer, correct?However, at the same time,if you do a mammographyand then perhaps you’ll find
that it’s intraductal papilloma.
03:12
Serous and bloody
nipple discharge,slight increase in the
risk for breast cancer.
03:17
But for the most part, benign.
03:19
Intraductal papilloma.
03:21
We have phyllodes tumor.
03:23
A phyllodes tumor.
03:24
Well, here, what I’d like you
to do is compare and contrastyour fibroadenoma
to phyllodes.
03:32
It’s pretty much a
derivative of it.
03:34
I’m not going to spend a
lot of time with this.
03:36
Understand that the
description herein the clinical characteristics
will be quite different.
03:43
If it’s small and fibroadenoma,
it will be large and bulky.
03:47
In fact, we call this
“leaf-like projections”and you might have cysts.
03:54
Characterstics become of utmost
importance for you with phyllodes.
03:58
I would know fibroadenoma
in greater detail.
04:01
Most common with phyllodes
will be in the?Look at your age group here.
04:05
If it’s a patient who’s a young
female, with fibroadenoma.
04:09
Your patient with phyllodes will be
an elderly patient, sixth decade.
04:13
And with phyllode tumor,
because of a larger size,there might be a greater chance
of going onto breast cancer.
04:20
So as you go through phyllode,
you’re comparing and contrastingthis with fibroadenoma.
04:24
When you go into fibroadenoma,you’re comparing and contrasting
this with fibrocystic change.
04:29
And if you’re thinking
about bloody nipple,maybe perhaps and hopefully
it’s just a benign tumorknown as an intraductal papilloma
by the lactiferous sinus.

About the Lecture

The lecture Benign Breast Conditions: Overview of Types by Carlo Raj, MD is from the course Breast Disease.

Included Quiz Questions

Which of the following breast conditions is most likely to occur in women after menopause?

Phyllodes tumor

Intraductal papilloma

Acute mastitis

Fibrocystic changes

Fibroadenoma

Which of the following is TRUE for both fibroadenoma and fibrocystic changes?

Size fluctuates in response to estrogen

Well-encapsulated mass

It is difficult to palpate on gross examination

Both increase risk for breast carcinoma

It may be hemorrhagic on removal

Which of the following statements about intraductal papilloma is INCORRECT?

It is the most common tumor in women less than 35 years old

It is a small tumor of lactiferous ducts

It may present with bloody or serous discharge

It has a slight increase in risk for carcinoma

It is typically located beneath the areola

Author of lecture Benign Breast Conditions: Overview of Types

Carlo Raj, MD

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